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Human Reproduction, Vol. 18, No. 9, 1836-1840, September 2003
© 2003 European Society of Human Reproduction and Embryology

Cumulative delivery rates after ICSI treatment cycles with freshly retrieved testicular sperm: a 7-year follow-up study

Kaan Osmanagaoglu1, Valerie Vernaeve, Efstratios Kolibianakis, Herman Tournaye, Michel Camus, Andre Van Steirteghem and Paul Devroey

Center for Reproductive Medicine, Dutch-speaking Brussels Free University, Brussels, Belgium

1 To whom correspondence should be addressed. e-mail: osmanagaoglu{at}hotmail.com

BACKGROUND: The purpose of this study was to assess cumulative delivery rates in patients with non-obstructive or obstructive azoospermia following treatment by testicular sperm extraction (TESE)–ICSI. METHODS: A cohort follow-up study was conducted. Between January 1994 and December 2000, 364 couples with obstructive azoospermia underwent a total of 609 fresh TESE–ICSI treatment cycles. In addition, 303 fresh TESE–ICSI treatment cycles were performed in 235 couples for non-obstructive azoospermia. This study included only patients in whom sperm was recovered. In the non-obstructive group, only patients with maturation arrest, atrophic sclerosis and germ cell aplasia were included. The main outcome measure was a delivery beyond 25 weeks gestation. RESULTS: In patients with obstructive azoospermia, the crude delivery rate after three cycles was 35% while the expected cumulative delivery rate was 48% [95% confidence interval (CI), 41–55]. On the other hand, in patients with non-obstructive azoospermia, the crude cumulative delivery rate after three treatment cycles was 17% while the expected delivery rate was 31% (95% CI, 15–46). A high dropout rate in couples with both non-obstructive and obstructive azoospermia was observed (75 and 50% respectively, after the first cycle). CONCLUSION: This study shows that there is a value in performing several TESE–ICSI attempts in patients with obstructive and non-obstructive azoospermia. The estimates of the non-obstructive group beginning from the third cycle are less reliable due to fewer patients. However, overall, the obstructive group performed better than the non-obstructive group.

Key words: cumulative pregnancy rates/life-table/non-obstructive azoospermia/obstructive azoospermia/TESE-ICSI


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